| NPI | 1487624458 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NY 307776) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01073579A) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MI 4301074988) | |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2021-03-31 |